Really need your advice from experienced nurses?

nurseprnRN, BSN, RN · Jan 29, 2014

If you are able to hear well enough c your implants to listen to your patients' speech, breath sounds, BPs, bowel sounds, and all the other verbal and auditory input you need to be responsible for in care settings, and so forth, you can at least graduate from nursing school. Then you can look for work in a place where your hearing is less of an issue, for example, in a Deaf-serving community clinic or a cochlear implant practice, even. If your hearing is adequate, you can work anywhere. If it isn't then you could have a real problem in a setting that requires adequate hearing.

But what I hear you saying is that you don't think your speech is OK. Is that because you hear yourself, or just because you hang out with a bunch of people who are new to you and don't seem to understand your speech? Do you have other independent confirmation of your speech being worse/less intelligible/less intelligible than others with cochlear implants?

You have to have health insurance now. Get your PCP or implant surgeon/clinic to prescribe speech therapy, it's a legitimate medical need. You can have an initial eval at no cost (insurance always pays for initial evals) so maybe that would help you decide where to go from here. I wish I had a more intelligent answer, but it's a place to start. Let us know what happens.

TheCommuter, BSN, RN · Jan 29, 2014

I work with multiple nurses from foreign countries (Bosnia, Zimbabwe, Kenya, the Philippines, etc.) whose heavily accented English is very difficult, and sometimes impossible, for many patients to understand. I know that broken English is not the same as speech impediment issues due to hearing impairment, but I do not see why it would keep you out of nursing.

Some of your older hard-of-hearing patients will not understand you and other patients might become frustrated when listening to you, but these same folks react in the same manner when dealing with nursing staff who speak strongly accented English as a second language.

LadyFree28, BSN, LPN, RN · Jan 29, 2014

I would talk to your advisor for guidance, and make sure to check in with her during your journey through nursing school.

Also understand that it will take others to get used to understanding you; I think it WILL pass. If you want to check in with a speech therapist, do so if you want to be comfortable.

Please don't doubt your abilities, especially if you are able to go through the program as GrnTea described; you have options and opportunities.

Best wishes!

succinate · Jan 29, 2014

If you are able to hear well enough c your implants to listen to your patients' speech, breath sounds, BPs, bowel sounds, and all the other verbal and auditory input you need to be responsible for in care settings, and so forth, you can at least graduate from nursing school. Then you can look for work in a place where your hearing is less of an issue, for example, in a Deaf-serving community clinic or a cochlear implant practice, even. If your hearing is adequate, you can work anywhere. If it isn't then you could have a real problem in a setting that requires adequate hearing.

But what I hear you saying is that you don't think your speech is OK. Is that because you hear yourself, or just because you hang out with a bunch of people who are new to you and don't seem to understand your speech? Do you have other independent confirmation of your speech being worse/less intelligible/less intelligible than others with cochlear implants?

You have to have health insurance now. Get your PCP or implant surgeon/clinic to prescribe speech therapy, it's a legitimate medical need. You can have an initial eval at no cost (insurance always pays for initial evals) so maybe that would help you decide where to go from here. I wish I had a more intelligent answer, but it's a place to start. Let us know what happens.

My hearing is good, I can always adjust my hearing so that I am able to hear all the sounds. In fact, I can get a modified stethoscope so that the sounds from the bowel sounds, breathing, BPs, et cetera are amplified. It works great - the sounds are crisp which is perfect. I have no problem with understanding what patients are saying, although they will need to speak slowly and clearly. I know I will have problems with seniors who might not yell at the top of their lungs so I can hear them or they might mumble, or a patient may have a tracheotomy (sp?) that s/he may mumble. I know I will face challenges but I believe if I remain alert and listen to the patients carefully, I can overcome these obstacles.

The problem is my own speech. GrnTea, what you said perfectly describes my feelings. I may be going crazy with my own speech. I can still speak to my mother or best friend and they can understand me perfectly fine but this is because they have exposure to my speech. I had one session with a speech language pathologist a few months ago and she noticed that I need to work on certain letters like these: /p/, /b/, /f/, /th/ and /r/. It's a lot but that session was the only first and last encounter I had with any speech therapist. Therefore she recommended that I get private speech therapy BUT what's ironic is that she even told me that she's not too concerned about my speech. In fact, when I talk to other speech therapists - of course they have a lot of experience with working with people who have speech problems - and they told me that my speech is very understandable although I need to work on some certain sounds.

Last year I had a job in a local hospital and this required talking to patents (by no means in a professional/medical way) and I was able to have a conversation with many of them without any problem. But now that I'm in university and lonely, I am starting to feel that my speech is getting worse. Now I have to check if this is true or not by talking to another speech therapist and hear her/his input, but I haven't met one. So this could be in my head. I don't know. When I speak to my professors or TA's, they had no problems with me. But with other students, yes most of them do not get me. I don't know the reason behind this pattern. I'm seriously going crazy.

This insanity that is slowly creeping into my head is now giving me doubts as to stay in nursing or not. I believe that if I have speech therapy (even though it's expensive) throughout the nursing school, my speech should be better in the future than it is now.

succinate · Jan 29, 2014

I work with multiple nurses from foreign countries (Bosnia, Zimbabwe, Kenya, the Philippines, etc.) whose heavily accented English is very difficult, and sometimes impossible, for many patients to understand. I know that broken English is not the same as speech impediment issues due to hearing impairment, but I do not see why it would keep you out of nursing.
Some of your older hard-of-hearing patients will not understand you and other patients might become frustrated when listening to you, but these same folks react in the same manner when dealing with nursing staff who speak strongly accented English as a second language.

It sounds like I'm very sensitive to how people react to me when I open my mouth to say a single word. When I see people get frustrated, I become sensitive, primarily because I haven't come to terms with my speech. So...I guess I need to start speech therapy soon.

ICUNurseStat · Jan 29, 2014

I can't help but wonder if your fellow students are just acting like you're so difficult to understand. Unfortunately, even adults sometimes gang up and pick on people who are different. Don't let their attitudes deter you from becoming a nurse.

As another poster replied, there are lots of nurses (and doctors) whose accents make them tough to understand. Language barriers also make it difficult for them to fully understand what patients are trying to tell them. This is truly not that different from your speech and hearing difficulties.

If nursing is what you want to do to create a better life for yourself, keep at it and don't get up. Also, when you find a job, you will likely have health insurance that will cover speech therapy.

succinate · Jan 29, 2014

My fellow nursing peers do act sometimes rude. They are idiots - they are like "what what what what what what" when they are really lazy to put in effort to understand my speech. Sometimes I would say one word like "Hello!" and they would be like :bugeyes: . I mean, c'mon? Yes, I have unfortunately experienced adults who were very judgmental towards me because of my speech.

Unfortunately I live in Canada and we do have health insurance, but it does not cover speech therapy once we turn 18.

Cobweb · Jan 30, 2014

You might be suffering from some anxiety issues, also, which could be why your speech seems clearer in some circumstances. Does your campus have counselors? Also, is there a speech therapy department at your school? Maybe some students would like to practice on you for free :)

nurseprnRN, BSN, RN · Jan 30, 2014

Cobweb has some good ideas. If there isn't a speech therapy course at your school, check the local university that might have one, and see if you can be a client in their teaching clinic. You could even offer to trade off on information on what you're learning in nursing, or offer to be the subject of a teaching seminar for them with their faculty. Free is free. :)

As for your classmates who seem to be the only ones with a significant problem, that tells me that, well, they're the ones with the problem. They do sound immature and jerkish, and someday, to be charitable, they will reflect back on these times and be adult enough to be embarrassed. Meanwhile I think you can safely ignore them if your communication with everybody else is ok.

As for understanding older or debilitated patients with whispery voices or bad diction, well, we all have problems understanding them, and we do what you will do: go for nonverbal cues, trial and error, and doing the best we can.

:flwrhrts:

neverbethesame · Jan 30, 2014

Here in the US we have Vocational Rehabilitation which helps people with disabilities. All 50 states have them as it's a federal program. I listed New York's here so you could look at it and see if Canada has an equivalent type of service. Good luck!!

Vocational Rehabilitation : VR :: ACCES :: NYSED